This guest post is by Charlotte Conway. Charlotte’s research interests are the uses of personal narratives and recovery stories within the Hearing Voices Movement. To read more about Charlotte, click here.
As he enters the ward, the man nervously surveys his surroundings. I approach him, smile, introduce myself and offer my hand. He goes to shake it but changes his mind. He looks back as the door to the outside world clicks shut and locks behind him.
I offer him a seat in one of the small interview rooms. He sits down, shuffles around in his chair for a moment then stands up again. His eyes dart around the room. He sits down again, wringing his hands. He looks over his shoulder, shakes his head and mutters to himself. I ask him if he’s hearing voices. He tells me that he is and asks if he’s been followed…
There are very few clues about a person’s story when they are first admitted to hospital. Information is often third hand, discussing the person in terms of symptoms and risk. I have no sense of who they are as a person, what motivates them, what they have achieved and what hardships they have endured. Away from their usual surroundings, from the context which reflects what is unique about them, they are stripped of their identity. I see a person who is often scared, disorientated and confused. But this is merely a snapshot of that person in time.
Overwhelmed by their experiences, their story is often fragmented and difficult to piece together. They may have difficulty communicating it, struggling to make themselves heard over the voices that are speaking to them.
They may have been sectioned and brought to hospital against their will, often with the assistance of the police. Angry and mistrustful, their story becomes something which is guarded and kept hidden from nurses and doctors. During their lives, so often characterised by perseverance and endurance, many methods of coping are developed, with the hardships they have experienced held closely. Many have been carrying secrets around with them for years. When they have tried to tell their story, they may not have been listened to or believed.
Soon after arriving on the ward, people are clerked in by a doctor. Here, they begin to be taught how to view their experiences as symptoms and are given the medical language they need to do this. They are asked about their mood, sleep, diet and if they have any thoughts of suicide. They are asked if they are hearing voices, feeling paranoid or if they believe they have any special powers. They are asked what has happened in the weeks leading up to the admission, but not what has happened generally in their lives.
Throughout their admission, people’s stories are often supressed. The environment is just not conducive to hearing them. At meal times, nurses are discouraged from sitting down and eating with patients. Instead, a member of staff sits in the corner, observing people and ticking them off as they enter the room and collect their food. And a perfect opportunity for the sharing of stories is lost.
Dedicated and hardworking nurses struggle to cope with the demand on beds, increasing paperwork and inadequate staffing levels. Resources are being stretched to breaking point and exhausted nurses must do their best in chaotic and stressful circumstances. In an environment where every second of time is accounted for, spending meaningful time with someone and hearing their story is a luxury that cannot always be afforded. Faced with a ward full of distressed and often suicidal patients, it’s heart-breaking not to be able to give people the time they deserve. Often the go-to solution for busy nursing staff who want to help relieve someone’s suffering, is to give them extra medication. In the short term it works, but most nurses are all too aware that in reality, you’re offering a solution which is temporary and often encourages dependence…
Morning medication. A queue forms outside the clinic room door. The plastic tots are lined up and carefully filled with water. A bowl is put out to collect the empties, the key unlocks the drug trolley and the door is opened. A woman slowly enters the room. She is carrying a cold cup of coffee in one hand and a cigarette in the other. The ward feels warm, but she is wearing a thick woollen jumper and a heavy sheepskin coat. The weathered skin on her face looks clammy and her eyes are puffy. Emptying each of her tablets into a tot, I hand them to her and ask her how she slept. She tells me she slept better last night and the voices weren’t as bad. I smile at her and she tells me I look tired. She’s right. I didn’t sleep well last night. After working a late shift, I got home and set my alarm for 5.30am. I had a restless night full of strange dreams. I decide to tell her one.
Having previously told her about my forthcoming wedding, I describe my dream in which I was standing in front of my friends and family reciting my vows. As I look down, to my horror, I realise that I’m completely naked. This makes her laugh. She takes my hand and tells me I’ll be okay. I ask her if she was nervous before she got married. She tells me about the morning of her wedding, describes struggling into her 1970s satin dress. And in this way, I start to finally get a glimpse of who this lady once was…
Charlotte Conway